scholarly journals Comparison of miRNA expressions among benign, premalignant and malignant lesions of the larynx: could they be transformation biomarkers?

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Fatma Ruya Tuncturk ◽  
Ibrahim Akalin ◽  
Lokman Uzun ◽  
Tulay Zenginkinet
Keyword(s):  
Treatment Options ◽  
Premalignant Lesions ◽  
Gene Expressions ◽  
Laryngeal Lesions ◽  
Malignant Group ◽  
Malignant Lesions ◽  
Polymerase Chain ◽  
Benign Group ◽  
Malignancy Potential

Abstract Background The malignancy potential of the laryngeal lesions are one of the major concerns of the surgeons about choosing the treatment options, forming surgical margins, deciding the follow-up periods. Finding a biomarker to overcome these concerns are ongoing challenges and recently microRNAs (miRNAs) are attributed as possible candidates since they can regulate gene expressions in the human genome. The objective of our study was to investigate their capability as a transformation biomarker for malignant laryngeal lesions. Materials and methods We investigated mature miRNA expressions in paraffin-embedded surgical specimens of human laryngeal tissues grouped as benign, premalignant or malignant (n = 10 in each). miRNA profiling was carried out by quantitative Real-Time polymerase chain reaction (RT-qPCR) and data were analyzed according to fold regulation. Results Our results demonstrated that 9 miRNAs were upregulated as the lesions become more malignant. Among them Hs_miR-183_5p, Hs_miR-155_5p, and Hs_miR-106b_3p expressions were significantly 4.16 (p = 0.032), 2.72 (p = 0.028) and 3.01 (p = 0.022) fold upregulated respectively in premalignant lesions compared to the benign lesions. Moreover, their expressions were approximately 2.76 fold higher in the malignant group than in the premalignant group compared to the benign group. Besides them, significant 7.57 (p = 0.036), 4.45 (p = 0.045) and 5.98 (p = 0.023) fold upregulations of Hs_miR-21_5p, Hs_miR-218_3p, and Hs_miR-210_3p were noticed in the malignant group but not in the premalignant group when compared to the benign group, respectively. Conclusion MiRNAs might have important value to help the clinicians for their concerns about the malignancy potentials of the laryngeal lesions. Hs_miR-183_5p, Hs_miR-155_5p, and Hs_miR-106b_3p might be followed as transformation marker, whereas Hs_miR-21_5p, Hs_miR-218_3p, and Hs_miR-210_3p might be a biomarker prone to malignancy.

scholarly journals Application of ultrasound artificial intelligence in the differential diagnosis between benign and malignant breast lesions of BI-RADS 4A

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sihua Niu ◽  
Jianhua Huang ◽  
Jia Li ◽  
Xueling Liu ◽  
Dan Wang ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Differential Diagnosis ◽  
Breast Imaging ◽  
Texture Features ◽  
Matrix Analysis ◽  
Width Ratio ◽  
Malignant Group ◽  
Malignant Lesions ◽  
Occurrence Matrix ◽  
Benign Group

Abstract Background The classification of Breast Imaging Reporting and Data System 4A (BI-RADS 4A) lesions is mostly based on the personal experience of doctors and lacks specific and clear classification standards. The development of artificial intelligence (AI) provides a new method for BI-RADS categorisation. We analysed the ultrasonic morphological and texture characteristics of BI-RADS 4A benign and malignant lesions using AI, and these ultrasonic characteristics of BI-RADS 4A benign and malignant lesions were compared to examine the value of AI in the differential diagnosis of BI-RADS 4A benign and malignant lesions. Methods A total of 206 lesions of BI-RADS 4A examined using ultrasonography were analysed retrospectively, including 174 benign lesions and 32 malignant lesions. All of the lesions were contoured manually, and the ultrasonic morphological and texture features of the lesions, such as circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, margin lobulation, energy, entropy, grey mean, internal calcification and angle between the long axis of the lesion and skin, were calculated using grey level gradient co-occurrence matrix analysis. Differences between benign and malignant lesions of BI-RADS 4A were analysed. Results Significant differences in margin lobulation, entropy, internal calcification and ALS were noted between the benign group and malignant group (P = 0.013, 0.045, 0.045, and 0.002, respectively). The malignant group had more margin lobulations and lower entropy compared with the benign group, and the benign group had more internal calcifications and a greater angle between the long axis of the lesion and skin compared with the malignant group. No significant differences in circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, energy, and grey mean were noted between benign and malignant lesions. Conclusions Compared with the naked eye, AI can reveal more subtle differences between benign and malignant BI-RADS 4A lesions. These results remind us carefully observation of the margin and the internal echo is of great significance. With the help of morphological and texture information provided by AI, doctors can make a more accurate judgment on such atypical benign and malignant lesions.

scholarly journals Study of laryngeal lesions undergoing microlaryngeal surgery in a tertiary health centre

2020 ◽  
Vol 6 (6) ◽  
pp. 1167
Author(s):  
Gangadhara K. S. ◽  
Chaitanya Vadva ◽  
Sridhara S.
Keyword(s):  
Vocal Cord ◽  
Health Centre ◽  
Cost Effective ◽  
Ratio Analysis ◽  
Good Tool ◽  
Laryngeal Lesions ◽  
Malignant Lesions ◽  
Microlaryngeal Surgery

<p class="abstract"><strong>Background:</strong> Patients with laryngeal lesions were evaluated for age and sex ratio, analysis of clinical features, videolaryngoscopic findings and histopathological features. Assessment of therapeutic role of microlaryngeal surgery (MLS) by telescopic method and also prognosis after surgery and voice therapy were evaluated.</p><p class="abstract"><strong>Methods:</strong> A prospective institutional based study. A total of 18 patients with vocal cord lesions the chief complaint being hoarseness of voice were subjected to surgery in a tertiary health centre. After thorough evaluation patients underwent MLS by telescopic method.  </p><p class="abstract"><strong>Results:</strong> In our study 6 patients stand out to be benign lesions and 12 patients stand out to be pre malignant and malignant lesions. Improvement in voice after surgery was reported in all patients. No recurrence was reported after 6-8 months of follow-up.</p><p class="abstract"><strong>Conclusions:</strong> MLS is a good tool as it is precise and cost effective. MLS by telescopic method is a good therapeutic tool in both benign and malignant vocal cord lesions.</p>

scholarly journals Application of ultrasound artificial intelligence in the differential diagnosis between benign and malignant breast lesions of BI-RADS 4A

2020 ◽  
Author(s):  
Sihua Niu ◽  
Jianhua Huang ◽  
Jia Li ◽  
Xueling Liu ◽  
Dan Wang ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Differential Diagnosis ◽  
Breast Imaging ◽  
Texture Features ◽  
Matrix Analysis ◽  
Width Ratio ◽  
Malignant Group ◽  
Malignant Lesions ◽  
Occurrence Matrix ◽  
Benign Group

Abstract Background: The classification of Breast Imaging Reporting and Data System 4A (BI-RADS 4A) lesions is mostly based on the personal experience of doctors and lacks specific and clear classification standards. The development of artificial intelligence (AI) provides a new method for BI-RADS categorisation. We analysed the ultrasonic morphological and texture characteristics of BI-RADS 4A benign and malignant lesions using AI, and these ultrasonic characteristics of BI-RADS 4A benign and malignant lesions were compared to examine the value of AI in the differential diagnosis of BI-RADS 4A benign and malignant lesions.Methods: A total of 206 lesions of BI-RADS 4A examined using ultrasonography were analysed retrospectively, including 174 benign lesions and 32 malignant lesions. All of the lesions were contoured manually, and the ultrasonic morphological and texture features of the lesions, such as circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, margin lobulation, energy, entropy, grey mean, internal calcification and angle between the long axis of the lesion and skin, were calculated using grey level gradient co-occurrence matrix analysis. Differences between benign and malignant lesions of BI-RADS 4A were analysed.Results: Significant differences in margin lobulation, entropy, internal calcification and ALS were noted between the benign group and malignant group (P=0.013, 0.045, 0.045, and 0.002, respectively). The malignant group had more margin lobulations and lower entropy compared with the benign group, and the benign group had more internal calcifications and a greater angle between the long axis of the lesion and skin compared with the malignant group. No significant differences in circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, energy, and grey mean were noted between benign and malignant lesions.Conclusions: Compared with the naked eye, AI can reveal more subtle differences between benign and malignant BI-RADS 4A lesions. These results remind us carefully observation of the margin and the internal echo is of great significance. With the help of morphological and texture information provided by AI, doctors can make a more accurate judgment on such atypical benign and malignant lesions.

scholarly journals Estimation of Some Breast Cancer Tumor Markers Using Flow cytometry

2017 ◽  
Vol 1 (3) ◽  
Author(s):  
Bossina Ahmed Ibrahim Khalid, Mona Samy Othman Gouida, Magdy
Keyword(s):  
Breast Cancer ◽  
Caspase 3 ◽  
Annexin V ◽  
S Phase ◽  
Control Group ◽  
Caspase 8 ◽  
Response To Chemotherapy ◽  
Malignant Group ◽  
Benign Group

Objective: The aim of this study was to estimate some tumor markers such as caspase-3, caspase-8 and annexin-v levels in blood and tissue of patients with breast cancer and establishing the relation between these apoptotic markers level and response to chemotherapy. Materials and Methods: A number of 150 females were divided into four groups, malignant neoplasm of breast cancer included 50 females, that were diagnosed into stage I, II, III, and IV and included inflammatory breast carcinoma, infiltrating ductal carcinoma, infiltrating lobular carcinoma, ductal carcinoma in situ and lobular carcinoma in situ, control group included 50 females with normal breast, benign neoplasm of breast cancer included 25 cases that contained  a heterogeneous group of lesions including developmental abnormalities, epithelial and stromal proliferations and neoplasms and follow up group (after chemotherapy) include 25 cases that her surgery was done and taken chemotherapy. Flow cytometry was used to analyze cell cycle, caspase-3, caspase-8 and annexin-v among the study groups. Results: The results showed that caspase 3 and caspases-8 expressions were significantly decreased in malignant group compared with the control group (P = 0.0028 and P =0.008), respectively; caspase 3 and caspase-8 levels decreased significantly in malignant group compared with the follow up group (P =0.001and P =0.0105), respectively; caspase 3 and caspases-8 levels were decreased in benign group compared with the control group (P = 0.041and P =0.512). Annexin-v was highly expressed in both tissues and blood of malignant groups in viable stage than benign compared with the normal groups (P = 0.01 and P = 0.006) respectively. Annexin-v level was highly expressed in both tissues and blood of malignant groups in necrotic stage compared with the control and follow up groups (P = 0.0001 and P = 0.01). But in early and late apoptotic phase follow up group annexin-v level was significantly increased more than the malignant group with (P=0.0001 and P=0.0026) respectively. Sub G1 apoptosis level in malignant and benign group significantly decreased compared with the follow up group (P = 0.0001 and P = 0.003) respectively. Our data showed that S phase level was significantly increased among malignant group compared with the control and follow up groups (P = 0.0001), also S phase level was increased significantly among benign group more than the control and follow up groups (P= 0.9 and P=0.003) respectively; and S phase was significantly decreased in benign group compared with the malignant blood and tissue groups (P = 0.03 and P=0.05) respectively. Conclusion: Annexin-v, caspase-3 and caspase-8 level in blood and tissue may serve as markers for the diagnosis of breast cancer and the response to chemotherapy. Also, S phase of cell cycle is one of the significant factors in the development of breast cancer.

scholarly journals Application of Ultrasound Artificial Intelligence in the Differential Diagnosis Between Benign and Malignant Breast Lesions of BI-RADS 4A

2020 ◽  
Author(s):  
SIHUA Niu ◽  
Jianhua Huang ◽  
Jia Li ◽  
Xueling Liu ◽  
Dan Wang ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Differential Diagnosis ◽  
Breast Imaging ◽  
Matrix Analysis ◽  
Width Ratio ◽  
Grey Level ◽  
Edge Roughness ◽  
Malignant Group ◽  
Malignant Lesions ◽  
Benign Group

Abstract Background: The classification of Breast Imaging Reporting and Data System 4A (BI-RADS 4A) lesions is entirely based on the personal experience of doctors and lacks specific and clear classification standards. The development of artificial intelligence (AI) provides a new method for BI-RADS category. We analysed the morphological and texture characteristics of BI-RADS 4A benign and malignant lesions using AI, and the ultrasonic characteristics of BI-RADS 4A benign and malignant lesions were compared to examine the value of AI in the differential diagnosis of BI-RADS 4A benign and malignant lesions.Methods: A total of 206 lesions of BI-RADS 4A examined using ultrasonography were analysed retrospectively, including 174 benign lesions and 32 malignant lesions. All of the lesions were contoured manually, and the morphological and texture features of the lesions, such as circularity, depth-to-width ratio, number of spicules, edge roughness, edge fuzziness, margin lobules, energy, entropy, mean grey level, grey level variance, grey level similarity, internal calcification and angle between the long axis of the lesion and skin（ALS） of the ROI, were calculated using grey level gradient co-occurrence matrix analysis. The differences between benign and malignant lesions of BI-RADS 4A were analysed.Results: There were significant differences between the benign group and malignant group in margin lobules, entropy, internal calcification and ALS (P=0.013, 0.045, 0.045, 0.002, respectively). The malignant group had more margin lobules and lower entropy than the benign group, and the benign group had more internal calcification and a larger ALS than the malignant group. There were no significant differences in circularity, depth-to-width ratio, number of spicules, edge roughness, edge fuzziness, energy, mean of grey level, grey level variance, and grey level similarity between benign and malignant lesions.Conclusion: For benign and malignant lesions of BI-RADS 4A, margin lobules and internal echo uniformity are the critical points of differentiation. Some of the characteristics of atypical benign and malignant lesions are blurry or even inverted, which may lead to a deviation of the characteristics of benign and malignant lesions.

scholarly journals Clinical significance of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography in the follow-up of colorectal cancer: searching off approaches increasing specificity for detection of recurrence

2017 ◽  
Vol 51 (4) ◽  
pp. 378-385 ◽  
Author(s):  
Semra Ince ◽  
Kursat Okuyucu ◽  
Oguz Hancerliogulları ◽  
Engin Alagoz ◽  
Huseyin San ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pet Ct ◽  
Malignant Group ◽  
Fdg Pet Ct ◽  
Benign Group ◽  
Fluorine 18 Fluorodeoxyglucose

AbstractBackgroundNearly 40% of colorectal cancer (CRC) recurs within 2 years after resection of primary tumor. Imaging with fluorine-18-fluorodeoxyglucose (l8F-FDG) positron emission tomography/computed tomography (PET/CT) is the most recent modality and often applied for the evaluation of metastatic spread during the follow-up period. Our goal was to study the diagnostic importance of18F-FDG-PET/CT data of maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and the difference of SUVmax on dual-time imaging in CRC.Patients and methodsWe examined the SUVmax value of lesions on control or restaging18F-FDG-PET/CT of 53 CRC patients. All lesions with increased SUVmax values were confirmed by colonoscopy or histopathology. We compared PET/CT results with conventional imaging modalities (CT, MRI) and tumor markers (carbohydrate antigen 19-9 [Ca 19-9], carcinoembryonic antigen [CEA]).ResultsMean SUVmax was 6.9 ± 5.6 in benign group, 12.7 ± 6.1 in malignant group. Mean TLG values of malignant group and benign group were 401 and 148, respectively.18F-FDG-PET/CT was truely positive in 48% of patients with normal Ca 19-9 or CEA levels and truely negative in 10% of cases with elevated Ca 19-9 or CEA. CT or MRI detected suspicious malignancy in 32% of the patients and18F-FDG-PET/CT was truely negative in 35% of these cases. We found the most important and striking statistical difference of TLG value between the groups with benign and recurrent disease.ConclusionsAlthough SUVmax is a strong metabolic parameter (p = 0.008), TLG seems to be the best predictor in recurrence of CRC (p = 0.001); both are increasing the specificity of18F-FDG-PET/CT.

scholarly journals Application of ultrasound artificial intelligence in the differential diagnosis between benign and malignant breast lesions of BI-RADS 4A

2020 ◽  
Author(s):  
Sihua Niu ◽  
Jianhua Huang ◽  
Jia Li ◽  
Xueling Liu ◽  
Dan Wang ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Differential Diagnosis ◽  
Breast Imaging ◽  
Texture Features ◽  
Matrix Analysis ◽  
Width Ratio ◽  
Malignant Group ◽  
Malignant Lesions ◽  
Occurrence Matrix ◽  
Benign Group

Abstract Background: The classification of Breast Imaging Reporting and Data System 4A (BI-RADS 4A) lesions is mostly based on the personal experience of doctors and lacks specific and clear classification standards. The development of artificial intelligence (AI) provides a new method for BI-RADS categorisation. We analysed the ultrasonic morphological and texture characteristics of BI-RADS 4A benign and malignant lesions using AI, and these ultrasonic characteristics of BI-RADS 4A benign and malignant lesions were compared to examine the value of AI in the differential diagnosis of BI-RADS 4A benign and malignant lesions.Methods: A total of 206 lesions of BI-RADS 4A examined using ultrasonography were analysed retrospectively, including 174 benign lesions and 32 malignant lesions. All of the lesions were contoured manually, and the ultrasonic morphological and texture features of the lesions, such as circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, margin lobulation, energy, entropy, grey mean, internal calcification and angle between the long axis of the lesion and skin, were calculated using grey level gradient co-occurrence matrix analysis. Differences between benign and malignant lesions of BI-RADS 4A were analysed.Results: Significant differences in margin lobulation, entropy, internal calcification and ALS were noted between the benign group and malignant group (P=0.013, 0.045, 0.045, and 0.002, respectively). The malignant group had more margin lobulations and lower entropy compared with the benign group, and the benign group had more internal calcifications and a greater angle between the long axis of the lesion and skin compared with the malignant group. No significant differences in circularity, height-to-width ratio, margin spicules, margin coarseness, margin indistinctness, energy, and grey mean were noted between benign and malignant lesions.Conclusions: Compared with the naked eye, AI can reveal more subtle differences between benign and malignant BI-RADS 4A lesions. These results remind us carefully observation of the margin and the internal echo is of great significance. With the help of morphological and texture information provided by AI, doctors can make a more accurate judgment on such atypical benign and malignant lesions.

Premalignant and Malignant Lesions of the Heterotopic Pancreas in the Esophagus: a Case Report and Review of the Literature

2015 ◽  
Vol 24 (2) ◽  
pp. 235-239 ◽  
Author(s):  
Jan Ulrych ◽  
Vladimir Fryba ◽  
Helena Skalova ◽  
Zdenek Krska ◽  
Tomas Krechler ◽  
...  
Keyword(s):  
Case Report ◽  
Gastrointestinal Tract ◽  
Unusual Case ◽  
Accurate Diagnosis ◽  
Heterotopic Pancreas ◽  
Premalignant Lesions ◽  
Resected Specimen ◽  
Review Of The Literature ◽  
Severe Dysphagia ◽  
Malignant Lesions

Heterotopic pancreas is a congenital pathology of the gastrointestinal tract, particularly rare in the esophagus. Both symptomatology and findings during preoperative examinations are non-specific and therefore do not often lead to an accurate diagnosis, which is usually revealed only by histopathological assessment of a resected specimen. We report an unusual case of a patient suffering from severe dysphagia caused by heterotopic pancreas in the distal esophagus with chronic inflammation and foci of premalignant changes. This article also reviews 14 adult cases of heterotopic pancreas in the esophagus previously reported in the literature, with the aim of determining the clinical features of this disease and possible complications including rare premalignant lesions and malignant transformation. Especially with regard to those complications, we suggest that both symptomatic and incidentally found asymptomatic lesions should be resected.

Antiretroviral Treatment-Associated Labia Majora Lipohypertrophy: A Rare Case and Plastic Surgical Treatment Options

2017 ◽  
Vol 2 (1) ◽  
pp. 43
Author(s):  
Akmal Hisham ◽  
Devananthan Ilenghoven ◽  
Wan Syazli Wan Ahmad Kamal ◽  
Salina Ibrahim ◽  
Shah Jumaat Mohd Yussof
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Daily Living ◽  
Treatment Options ◽  
Hiv Positive ◽  
Highly Active ◽  
Labia Majora ◽  
The Face ◽  
Central Fat

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

Efficacy and safety of oral dapsone in acne vulgaris – experience of a tertiary care teaching hospital in central Lahore

2020 ◽  
Vol 14 (2) ◽  
pp. 87-90
Author(s):  
Sadaf Amin Chaudhry ◽  
Nadia Ali Zafar ◽  
Rabia Hayat ◽  
Ayesha Noreen ◽  
Gulnaz Ali ◽  
...  
Keyword(s):  
Side Effects ◽  
Therapeutic Option ◽  
Acne Vulgaris ◽  
Treatment Options ◽  
Tertiary Care ◽  
Poor Response ◽  
Global Assessment Scale ◽  
Severe Acne ◽  
Hematologic Profile

Background: Acne is the eighth most prevalent disease affecting 9.4% of the population worldwide and its prevalence in our country is estimated to be around 5%. Severe inflammatory acne is most likely to leave scars and in order to prevent facial disfigurement due to acne scarring, early treatment is desirable. Various treatment options have been formulated for acne, and are tailored according to the severity of the disease. Numerous clinical trials have been conducted till now, to determine the usefulness and side effect profile of such therapies, making acne treatment a highly studied area in dermatology. Objective of this study is to highlight the fact that oral Dapsone could be used as a cheaper alternate to isotretinoin in recalcitrant severe acne, especially in females where retinoids are sometimes contraindicated. Patients and methods: 51 patients, suffering from severe nodulocystic acne, fulfilling the criteria, were enrolled from the Department of Dermatology, Sir Ganga Ram Hospital, Lahore. All the study patients were given oral Dapsone 50mg for initial two weeks and then 100mg daily for the next 10 weeks along with oral cimetidine and topical clindamycin application twice daily. Investigator Global Assessment Scale (IGAS) was employed to measure effectiveness. The treatment was considered ʽeffectiveʹ if the patient achieves 2 or more than 2-grade improvement or almost clear or clear skin at the end of 12 weeks according to IGAS scale. The lesion counts were also done before the start of therapy (day 1) and at every two weeks follow up for 12 weeks. The change in lesion count observed between the baseline number and that seen at follow up visits was also used to evaluate the effectiveness of oral Dapsone. Safety was analyzed by fortnightly visits of the patients to look for any undesirable side effects and monitoring of the hematologic profile of the patients. Final follow up was done at the end of 16 weeks. Results: The study was conducted on 51 patients, with a ratio of 1:3 for males and females and a mean age of 25.2 years (SD ±5.81). At 12th week, patients had significant reduction in their acne lesions; with 7 patients (13.7%) showing completely clear skin, 17 patients (33.3%) had almost clear skin, 5 patients (9.8%) had 3-grade improvement. Twelve patients (23.5%) had 2-grade improvement from baseline score and only 2 patients (3.9%) had 1-grade improvement from baseline. Based on percentage reduction of lesions, excellent response was seen in 32 patients (62.7%), good response in 9 patients (17.6%), moderate response in 2 patients (3.9%), while no patient showed poor response. Dapsone was discontinued in 8 patients due to derangement of hematologic profile. Conclusion: Oral Dapsone, when given carefully, is a very effective therapeutic option in severe recalcitrant acne, with limited side effects.

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